burns and scalds first aid and prevention the nhsggc approach … · · 2014-10-09burns and...
Post on 24-Mar-2018
222 Views
Preview:
TRANSCRIPT
Burns and Scalds – First Aid and Prevention
The NHSGGC approach
Sharon Ramsay – Burns Nurse Specialist
Gregor Walker – Consultant Paediatric Surgeon
Lesley Nish – Health Improvement Senior
Presentation to Cross Party Group on Accident Prevention and Safety Awareness, 24/06/2014
Royal Hospital for Sick Children •Burns Team
–4 surgeons
–Burns Nurse Specialist
–Physiotherapists
–Dietician/psychology
•Emergency Department
•Burns Ward
–Cubicles
–Experienced nursing staff
•Dedicated theatre lists and out-patient clinics
Activity Data 2012
• ~450 emergency attendances/year
• 115 admissions to ward (192 in GRI)
0
10
20
30
40
50
60
70
80
Yorkhill GRI 31 hot drink scalds
nu
mb
er
Extent of injury/Treatment
0
10
20
30
40
50
60
70
<1% 1-5 6-10 11-20 20-40 41-50
Yorkhill GRI
Extent of Injury
(%TBSA)
% 16%
64%
9%
11%
Graft
Dressings
Skin substitutes
Exposed
Duration of stay 1-14 days
Burns - First Aid
• Remove from source
• Cool the wound
• Protective dressing/Analgesia
• EMSB Course – Cool running water for 20 mins
– Between 8-25oC (Ideally 15oC)
– Avoid ice
• Cooling is beneficial up to 1 hour post burn – Some evidence to suggest benefits up to 2 hours
Benefits of Cooling
• Analgesia
• Reduce tissue temp
• Reduce oedema
• Improved healing
From Nguyen et al. Burns;28:173-6, 2002
Superficial
Superficial Dermal
Deep Dermal
Full Thickness
Stasis
Hyperaemia
Coagulation
Public Awareness
• Intuitive
• First Aid Courses
• Minority cool effectively
from Graham et al Burns;38:438-43, 2012
12.8
17.9
5.1
35.9
28.2
0.0 5.0
10.0 15.0 20.0 25.0 30.0 35.0 40.0
None/toothpaste Cold towel Bath/Jug Running Water <10 mins
Running Water >10 mins
Background
• Multi partnership workshop to consider how bad the burns and scalds issue is in NHSGGC
• Engineering, Environmental, Enforcement, Education and Empowerment prevention options
• Short life working group set up to agree actions
• Consultation carried out with parents, carers and staff in NHSGGC
• Agreement on importance of first aid message and secondary prevention approach
Actions
• Funding secured to purchase first aid fridge magnets
• 50,000 magnets to be distributed across NHSGGC
• Brief Intervention with every family
• Successful event with pharmacists
• Launch with case study 12th June, 2014
– Extensive media coverage
– Facebook and Twitter
– RoSPA and NHSGGC websites
Distribution
• All families with babies at 10 day visit
• All children in Nursery Schools
• Local community venues focusing on ambulant toddlers
– GP practices
– Health improvement teams (6 regional teams)
– Mothers & toddlers groups
– Pre-5 centres/weaning centres
– Go Safe Scotland
– Soft play centres/Schools/swimming pools/sports centres
Evaluation/Further Actions
• Close the audit loop
• Follow-up assessment of pharmacy training
• Assess number of attendances/admissions
– Needs better data collection (attendances)
• Widen the message nationally
• Research on cold tap temperatures throughout year
• Undertake cost-benefit analysis
• Consider other primary prevention strategies
top related